Findings show that synonyms familiar to clinicians are often used to communicate prognoses in multidisciplinary meetings. In communication with patients and families, doctors rely on emotional and cultural cues to decipher the preferred terminology and response. Drawing on a late modern re-imagination of emotion management, we conceptualise the work performed in this context as emotionally reflexive labour. These findings suggest that blanket protocols for direct communication overlook the complexity of end-of-life communication in an era where a 'good death' is understood to be culturally relative. The older adult population is growing in number and diversity, and this population has unique care needs that the current healthcare system is ill prepared to meet. In order to ensure older adults receive safe, person-centered care that supports their goals, the John A. Hartford Foundation has developed and, with their partners at the Institute for Healthcare Improvement, the American Hospital Association, and Catholic Health Association of the United States, is implementing across the United States the Age-Friendly Health Systems Initiative. This article provides an overview of the Age-Friendly Health Systems Initiative and how within it nurses can serve as leaders in ensuring age-friendly care for older adults. Acute pulmonary emboli are a major cause of morbidity and mortality and require prompt evaluation, diagnosis, and treatment. To date, anticoagulation using low molecular weight heparin or non-Vitamin K oral anticoagulants has been the mainstay of treatment in the subset of patients in whom pulmonary embolism does not compromise hemodynamics. On the other hand however, patients with massive pulmonary embolism and shock, thrombolytic therapy is necessary. This raises the question whether ultrasound-assisted catheter directed thrombolytic delivery might be superior to systemic administration. This review article aims to consolidate recent literature to help achieve a better understanding toward the utility of catheter directed therapy. INTRODUCTION AND OBJECTIVES There are only thirty cases of rhabdomyolysis (RML) after laparoscopic partial nephrectomy (LPN) in the literature; no reports are available after robotic partial nephrectomy (RPN). Our objective is to describe the casuistry of the RML after RPN, as well as to review the clinical and analytical data of its presentation. MATERIAL AND METHODS Retrospective review (2011-2017) of patients who underwent RPN. The baseline characteristics and surgical data were collected. RML was characterized from a clinical and analytical point of view. RESULTS The review of 136 procedures showed an incidence of RML of 3.67% (5 patients), mainly young (mean 42 years; range 26-65) and obese men (mean 36.07kg/m2; range 30.3-48.6). The mean operative time was 194minutes (range 150-230). The key symptom for its suspicion was hip/gluteal region pain -contralateral to the operative site- in all cases. The median time to diagnosis was 6hours (range 6-48). Postoperative total creatine kinase (CK) reached its maximum level on the first postoperative day (mean 28,766.7IU/L; range 4,170-54,544). Treatment was based on hydration, with the use of diuretics and bicarbonate in case of acute renal failure (ARF). At discharge, all patients had mild gluteal region/hip pain; additionally, one patient presented walking difficulties (functional limitation). All patients were asymptomatic at 1 month and had no long-term sequelae. CONCLUSIONS RML after RPN is a rare complication that increases the morbidity and mortality of the procedure. It is important to know it in order to identify and treat it early. CYD-TDV is a live, attenuated, tetravalent dengue vaccine licensed in 21 countries. We undertook a post-hoc analysis of the long-term efficacy of CYD-TDV during the surveillance expansion phase (SEP) of two Phase III studies (CYD14 in the Asia-Pacific region; CYD15 in Latin America). The SEP included approximately Year 5 and the entire Year 6 of follow-up after the first study injection. Vaccine efficacy against symptomatic virologically-confirmed dengue (VCD) was assessed by participant age (any age, ?9, less then 9, 2-5, and 6-8&nbsp;years at the time of the first injection) and baseline dengue serostatus using a case-cohort framework. Baseline dengue serostatus was estimated by several methods including logistic regression-based multiple imputation (MI) to predict PRNT50 with key predictor being Month 13 (M13) anti-non-structural protein (NS1) titers; superlearner-based imputation by targeted minimum loss based estimation (TMLE); and M13 anti-NS1 titer threshold 9 EU/mL (NS1 M13). There were 436 symptomatic VCD cases (CYD14 n&nbsp;=&nbsp;360; CYD15 n&nbsp;=&nbsp;76) during the SEP. Vaccine efficacy in seropositive participants aged ?9&nbsp;years was assessed by MI (47.9% [95% CI 19.4; 66.3]), TMLE (53.0% [95% CI 23; 71]), and NS1 M13 (52.4% [95% CI 30.8; 67.3]). Vaccine efficacy estimates were lower in seropositive individuals aged less then 9&nbsp;years compared with individuals ?9&nbsp;years. Among seropositive individuals aged 2-5 and 6-8&nbsp;years, vaccine efficacy across the different approaches for assessing serostatus ranged from between -25.7 to 36.9% and 44.4 to 64.7% during the SEP, respectively. In the pooled CYD14/15 data of seronegatives, vaccine efficacy was null to modest. In conclusion, CYD-TDV was shown to maintain efficacy against symptomatic VCD in seropositive participants aged ?9&nbsp;years up to six years after the first dose. Persistence of efficacy was also observed in seropositive participants aged 6-8&nbsp;years. https://www.selleckchem.com/products/NXY-059.html Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, especially among children and the elderly. S. pneumoniae serotype 19A has emerged as a major cause of invasive disease in many countries, regardless of whether pneumococcal conjugate vaccines are used. The aim of this study was molecular characterization of invasive S. pneumoniae serotype 19A isolates recovered between 2000 and 2015 from 13 National Laboratories through the laboratory-based surveillance of invasive S. pneumoniae program SIREVA II in Latin American countries. The isolates were submitted with antimicrobial susceptibility tests and were genotyped by a combination of pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Of the 185 isolates assayed, notable rates of resistance to penicillin (MIC???0.125??g/mL; 68.6%), tetracycline (63.7%), trimethoprim-sulfamethoxazole (63.2%), and erythromycin (43.2%) were observed, while 44.3% of isolates were multidrug resistant. The most frequently observed sequence types (ST) were ST320 (32.